Sleep quality among inpatients with acute myeloid leukemia.

Abstract

82 Background: Anecdotally, sleep is thought to be a significant problem for inpatients receiving treatment for acute myeloid leukemia (AML), butsleep disturbances in this setting are not well-characterized. We aimed to assess the feasibility of measuring sleep in AML patients using a wearable actigraphy device. Methods: Using the Actigraph GT3X “watch,”we assessed the total sleep time, sleep onset latency, wake after sleep onset, number of awakenings after sleep onset, and sleep efficiency for inpatients with AML receiving induction chemotherapy during their hospitalization. We also assessed patient self-reported sleep quality using the Pittsburgh Sleep Questionnaire Index (PSQI). Results: Of the thirteen patients enrolled in the study, 11 completed actigraphy and PSQI assessments. Two patients who were transferred to the ICU were excluded from this analysis. Data collection was feasible; patients wore the Actigraph device for a mean (SD) of 120 (58) hours. Subjects’ mean age was 55.9 (15.7) years. Mean length of hospitalization was 34 (13) days. The mean PSQI global score was 8.10 (4.91) indicating generally poor sleep. Actigraphy measures also suggested poor sleep. Overall sleep quantity was insufficient, with a mean total sleep time in minutes of 366.5 (61.0). Patients’ sleep was often interrupted, with a mean number of awakenings after sleep onset of 4.9 (3.3), average awakening length in minutes of 7.8 (5.5), and mean wake after sleep onset in minutes of 37.2 (26.4). Mean sleep onset latency in minutes was 0.4 (0.5) and sleep efficiency was high (90.7% (0.1)), suggesting that patients did not have difficulty falling asleep but rather experienced poor sleep due to external factors. Conclusions: Actigraphy assessment of sleep in AML inpatients is feasible, and suggests significant impairments in both quantity and quality of sleep. While patients did not appear to have difficulty falling asleep, they experienced significant sleep disturbances, perhaps from external factors like interactions with staff and interruptions such as from administration of medications, lab draws and vital sign measurements. Supportive care interventions are needed to further improve sleep quantity and quality among inpatients with AML.